revenue cycle management

Health Insurance Call Centres Can’t Answer You. What Works Instead

Payer phone lines degraded for structural reasons: scripted staff with no authority to decide, adjudication questions the script cannot answer, and volume that gets managed rather than reduced. What to run instead, named from the source: the 270/271 eligibility transaction, 276/277 claim status, the 278 for authorisation, portals, the ERISA and external review appeal route, the CMS-0057-F prior authorisation dates, plus the desk design and vendor standards that make the phone channel’s cost visible.

What to Check Before Outsourcing Facility Medical Billing

Facility billing is not professional billing: different claim format, different payment system, different upstream data. What a hospital outpatient department or ASC should check before signing a billing vendor, from charge master ownership and OIG position on percentage-of-collections pricing to the metrics and cutover terms that decide whether it works.

Offshoring Healthcare Finance and RCM: What HIPAA Actually Requires

HIPAA does not prohibit sending PHI offshore, but it does not stop applying at the border. What the BAA chain, the Security Rule risk analysis and the CMS offshore subcontractor attestation actually require, which RCM work really moves, and the access controls that break first.

Medical Billing & Coding Outsourcing to India in 2026: How US Hospitals Are Recovering Lost Revenue

Discover why US healthcare providers are outsourcing medical billing and coding to India in 2026. Cut RCM costs by 60%, reduce claim denials by 35%, and accelerate cash flow with AB7 Solutions.